POS1161 CAN DOCTORS TREAT GOUT WELL? INSIGHT ON GOUT MANAGEMENT IN REFERRAL CENTRES
Authors: C. Jauffret, S. Ottaviani, A. Latourte, H. K. Ea, S. Graf, F. Lioté, T. Bardin, P. Richette, T. Pascart
Journal: Annals of the Rheumatic Diseases (2022)

Background Recent studies have shown a lack of implementation of gout recommendations in primary care. In this context of therapeutic inertia, the French Society of Rheumatology (SFR) published its first recommendations on gout (RECO) in 2020 [1,2], which were deliberately simple and concise. Objectives To determine the profile of patients referred to French gout expert centres, and to examine the results of their management. Methods Three hundred patients attending a first visit for gout management in three French referral centres were retrospectively included. Visits were performed at baseline (M0) and scheduled for month 6 (M6), month 12 (M12), and month 24 (M24). Data collected included: patient profile; disease activity and treatments; serum urate (SU) level; estimated glomerular filtration rate (eGFR). Results Patients were 81% male, mean age 62.2 ± 15.2 years, 42.7% prevalence of eGFR &lt;60ml/min/1.73m 2 , 28.1% diabetes mellitus, and 25.4% had a history of major cardiovascular event. Management followed French recommendations after the baseline visit in 94.9% of cases. Overall, 50 patients (16.7%) received off-label anakinra for flare treatment or flare prophylaxis. SU levels were below 6.0mg/dL in 59.4% of patients at M6, 67.9% at M12, and 78.6% at M24. At M24, 50% of patients were treated with allopurinol (313 ± 105 mg/d), which exceeded renal restrictions of doses in 61.5% of them, and 48.2% received febuxostat (84 ± 36mg/d). At inclusion, 94% of patients had experienced at least one flare in the previous six months, versus 23.6% at M12, and 13.1% at M24 (of which 8/12 (66.7%) had SU&gt;6.0mg/dL). Conclusion Simple application of gout management guidelines is feasible in clinical practice, and is efficient with a majority of patients achieving SU targets and clinical improvement. A minority of patients in referral centres have ‘difficult-to-treat’ gout requiring specific management. References [1]Latourte A, et al. 2020 Recommendations from the French Society of Rheumatology for the management of gout: Management of acute flares. Joint Bone Spine 2020;87:387-93. [2]Pascart T, et al. 2020 recommendations from the French Society of Rheumatology for the management of gout: Urate-lowering therapy. Joint Bone Spine 2020;87:395- 404. Disclosure of Interests Charlotte Jauffret: None declared, Sebastien Ottaviani: None declared, Augustin Latourte Consultant of: Novartis, Hang Korng Ea: None declared, Sahara Graf: None declared, Frederic Lioté Grant/research support from: for the European Crystal Network workshops from Astra-Zeneca, Grunenthal, Horizon Pharmaceuticals, Ipsen Pharma, Menarini France and global, Novartis France, Olatec, Selecta, SOBI, Thomas Bardin Consultant of: Astra-Zeneca, Biomex, Grunenthal, Horizon Pharmaceuticals, Ipsen Pharma, Menarini France and global, Novartis France, Savient and Sobi, Pascal Richette: None declared, Tristan Pascart Consultant of: from Novartis, Grant/research support from: from Horizon Pharmaceuticals, Novartis, Variant Bio